Journal of Thoracic Oncology最新文献

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A Response to the Letter to the Editor: “Lung Cancer Screening in Low-Risk Populations: Ethical Considerations, Technological Advancements, and Socioeconomic Challenges”

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.12.001

Gerard A. Silvestri MD, MS, Robert Young MD, PhD, DSc, Nichole T. Tanner MD, MS, Peter Mazzone MD, MPH

引用次数: 0

Tobacco News Update—From the IASLC Tobacco Control Committee

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.12.019

引用次数: 0

The Distance Toward Precision Medicine in SCLC

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.11.014

Ying-Long Peng MD , Zhi Guo MD , Qing Zhou MD

引用次数: 0

Concurrent Genomic Alterations on Clinical Outcomes in Patients With Alk-rearranged NSCLC

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.10.025

Leticia Bornstein-Quevedo MD, MSc, Alfonso Duenas-Gonzalez MD, PhD

引用次数: 0

A Response to the Letter to the Editor: “Secondhand Smoke in Low-Risk Groups: A Hidden Danger in Lung Cancer Screening”

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.10.023

Gerard A. Silvestri MD, MS, Robert Young MD, PhD, DSc, Nichole T. Tanner MD, MS, Peter Mazzone MD, MPH

引用次数: 0

A Response to the Letter to the Editor: “Failure to Include Nonsmokers in Computed Tomography Screening for Lung Cancer is Unjust”

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.12.002

Gerard A. Silvestri MD, MS, Robert Young MD, PhD, DSc, Nichole T. Tanner MD, MS, Peter Mazzone MD, MPH

引用次数: 0

Performance Optimization of Convolutional Neural Network Model Based on Attention Mechanism in Patients With NSCLC

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.06.018

Zhiwen Wang PhD, Linfeng Wang PhD, Gang Wang PhD

引用次数: 0

The Phase 3 KEYLYNK-006 Study of Pembrolizumab Plus Olaparib Versus Pembrolizumab Plus Pemetrexed as Maintenance Therapy for Metastatic Nonsquamous NSCLC Pembrolizumab联合Olaparib与Pembrolizumab联合培美曲塞作为转移性非鳞状非小细胞肺癌维持疗法的3期KEYLYNK-006研究。

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.10.026

Jhanelle E. Gray MD , Michael Schenker MD, PhD , Mehmet Ali Nahit Şendur MD , Viktoriya Leonova MD , Dariusz Kowalski MD, PhD , Terufumi Kato MD , Rashida Orlova MD , James Chih-Hsin Yang MD, PhD , Adrian Langleben MD , Arnold Pilz MD , Andrei Ungureanu MD , Milena Perez Mak MD , Flavia De Angelis MD , Himani Aggarwal PhD , Zachary Zimmer PhD , Bin Zhao MD, PhD , Mark Shamoun MD , Tae Min Kim MD, PhD

Introduction

Poly (adenosine diphosphate–ribose) inhibitors, including olaparib, upregulate programmed cell death ligand 1, which may increase the efficacy of anti–programmed cell death protein 1 and anti–programmed cell death ligand 1 therapies.

Methods

In the phase 3 KEYLYNK-006 trial (NCT03976323), eligible adults with previously untreated metastatic nonsquamous NSCLC without targetable genetic alterations who had complete response, partial response, or stable disease after induction therapy with four cycles of pembrolizumab 200 mg every three weeks, pemetrexed 500 mg/m², and carboplatin area under the concentration-time curve 5 mg/mL/min or cisplatin 75 mg/m² were randomized in a one-to-one ratio to olaparib 300 mg orally twice daily or pemetrexed every three weeks, both given with up to 31 cycles of pembrolizumab every three weeks. Dual primary endpoints were progression-free survival (PFS) and overall survival (OS). Progression-free survival was tested at interim analysis 2 (i.e., final PFS analysis) and OS at final analysis (FA).

Results

Of 1003 patients who received induction therapy, 672 (67.0%) were randomized to pembrolizumab plus olaparib (n = 337) or pembrolizumab plus pemetrexed (n = 335) in the intention-to-treat population. Median follow-up at FA was 39.9 (range: 28.1–51.5) months. At interim analysis 2, the median (95% confidence interval [CI]) PFS was 7.1 (5.6–8.7) months versus 8.3 (6.9–11.5) months in the olaparib versus pemetrexed groups (hazard ratio = 1.12, 95% CI: 0.92–1.36, p = 0.87). At FA, the median (95% CI) OS was 20.7 (18.0–24.8) months versus 23.0 (19.0–26.4) months (hazard ratio = 1.04, 95% CI: 0.87–1.25, p = 0.6649). Grade 3 to 5 maintenance treatment-related adverse events occurred in 26.1% versus 30.1% of patients, respectively.

Conclusion

Pembrolizumab plus maintenance olaparib did not improve PFS or OS versus pembrolizumab plus pemetrexed in previously untreated metastatic nonsquamous NSCLC without targetable genetic alterations.

背景：包括奥拉帕利在内的聚（ADP-核糖）抑制剂会上调程序性细胞死亡配体1（PD-L1），这可能会提高抗PD-(L)1疗法的疗效：在 KEYLYNK-006 3 期试验（NCT03976323）中，符合条件的既往未接受过治疗的转移性非鳞状 NSCLC 患者，如果没有可靶向的基因改变，且在接受 4 个周期的诱导治疗后出现完全应答 (CR)、部分应答 (PR) 或疾病稳定 (SD)，则随机分为 1：奥拉帕利（olaparib）300 毫克，口服，每天两次，或培美曲塞 Q3W，均与≤31 个周期的 pembrolizumab Q3W 同时进行。双重主要终点是无进展生存期（PFS）和总生存期（OS）。无进展生存期在中期分析2（IA2；即最终无进展生存期分析）时进行检测，OS在最终分析（FA）时进行检测：在1003名接受诱导治疗的患者中，672人（67.0%）随机接受了pembrolizumab联合奥拉帕利（337人）或pembrolizumab联合培美曲塞（335人）的意向治疗。FA的中位随访时间为39.9个月（28.1-51.5个月）。在IA2，奥拉帕利与培美曲塞组的中位（95% CI）PFS分别为7.1（5.6-8.7）个月和8.3（6.9-11.5）个月（HR，1.12；95% CI，0.92-1.36；P=0.87）。在FA，中位（95% CI）OS为20.7（18.0-24.8）个月对23.0（19.0-26.4）个月（HR，1.04；95% CI，0.87-1.25；P=0.6649）。3-5级维持治疗相关AE发生率为26.1%对30.1%：Pembrolizumab联合奥拉帕利维持治疗与Pembrolizumab联合培美曲塞相比，并不能改善既往未经治疗的无靶向基因改变的转移性非鳞状NSCLC患者的PFS或OS。

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引用次数: 0

Pembrolizumab With or Without Maintenance Olaparib for Metastatic Squamous NSCLC That Responded to First-Line Pembrolizumab Plus Chemotherapy Pembrolizumab 联合或不联合 Olaparib 治疗对一线 Pembrolizumab 加化疗有反应的转移性鳞状非小细胞肺癌。

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.10.012

Maximilian Hochmair MD , Michael Schenker MD, PhD , Manuel Cobo Dols MD , Tae Min Kim MD, PhD , Ozgur Ozyilkan MD , Maria Smagina MD , Viktoriya Leonova MD , Terufumi Kato MD , Alexander Fedenko MD , Flavia De Angelis MD , Achim Rittmeyer MD , Jhanelle E. Gray MD , Alastair Greystoke MBChB, MSc, PhD , Himani Aggarwal PhD , Qinlei Huang MS , Bin Zhao MD, PhD , Humberto Lara-Guerra MD, MSc, PhD , Ernest Nadal MD, PhD

Introduction

Poly (adenosine diphosphate-ribose) polymerase inhibitors can up-regulate programmed cell death-ligand 1 expression and promote immune-mediated responses and may improve efficacy of first-line anti‒programmed cell death protein 1‒based therapies in patients with metastatic squamous NSCLC.

Methods

In this randomized, double-blind, phase 3 trial (NCT03976362), adults with previously untreated stage IV squamous NSCLC received four cycles of induction therapy (pembrolizumab 200 mg every 3 weeks plus carboplatin and paclitaxel or nab-paclitaxel). Patients with disease control were randomized to 31 cycles of pembrolizumab 200 mg every 3 weeks plus olaparib 300 mg orally twice daily or placebo. Dual primary end points were progression-free survival (PFS) and overall survival (OS). PFS was tested at interim analysis 2 (the final PFS analysis); OS was tested at final analysis.

Results

A total of 851 patients received induction treatment; 296 were randomized to pembrolizumab plus olaparib and 295 to pembrolizumab plus placebo. At interim analysis 2, with median follow-up of 27.1 months, median (95% confidence interval [CI]) PFS was 8.3 (6.7‒9.7) months in the pembrolizumab plus olaparib group and 5.4 (4.1‒5.6) months in the pembrolizumab plus placebo group (hazard ratio = 0.77, 95% CI: 0.63‒0.93, p = 0.0040 [not significant at a one-sided superiority boundary of p = 0.003]). At final analysis, with median follow-up of 33.4 months, median (95% CI) OS was 19.1 (15.9‒22.2) and 18.6 (16.0‒21.6) months, respectively (hazard ratio = 1.01, 95% CI: 0.83‒1.24, p = 0.5481). Treatment-related adverse events occurred in 76.5% and 65.1% of patients, respectively.

Conclusions

Adding olaparib to pembrolizumab as maintenance therapy for metastatic squamous NSCLC did not significantly improve PFS versus pembrolizumab plus placebo; neither PFS nor OS met the prespecified statistical significance boundary. No new safety signals were identified.

Trial registration

ClinicalTrials.gov, NCT03976362.

背景：PARP抑制剂能上调PD-L1的表达并促进免疫介导的反应，可能会提高转移性鳞状NSCLC患者一线抗PD-1疗法的疗效：在这项随机、双盲、3 期试验（NCT03976362）中，既往未经治疗的 IV 期鳞状 NSCLC 成人患者接受了 4 个周期的诱导治疗（pembrolizumab 200 mg Q3W 加卡铂和紫杉醇或 nab-紫杉醇）。疾病得到控制的患者随机接受 31 个周期的 pembrolizumab 200 毫克 Q3W 加 olaparib 300 毫克口服，每天两次或安慰剂治疗。无进展生存期（PFS）和总生存期（OS）是双重主要终点。无进展生存期在中期分析2（IA2；最终无进展生存期分析）中进行检测；OS在最终分析中进行检测：851名患者接受了诱导治疗；296名患者随机接受了pembrolizumab加奥拉帕利治疗，295名患者随机接受了pembrolizumab加安慰剂治疗。在中位随访27.1个月的IA2阶段，pembrolizumab联合olaparib组的中位（95% CI）PFS为8.3（6.7-9.7）个月，pembrolizumab联合安慰剂组为5.4（4.1-5.6）个月（HR，0.77 [95% CI，0.63-0.93]；P=0.0040[单侧优效边界P=0.003时无显著性]。在中位随访 33.4 个月的最终分析中，中位（95% CI）OS 分别为 19.1（15.9-22.2）个月和 18.6（16.0-21.6）个月（HR，1.01 [95% CI，0.83-1.24]；P=0.5481）。分别有76.5%和65.1%的患者出现治疗相关不良事件：结论：与pembrolizumab加安慰剂相比，在转移性鳞状NSCLC的维持治疗中添加奥拉帕利并不能显著改善PFS，PFS和OS均未达到预设的统计学显著性界限。未发现新的安全信号。

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引用次数: 0

Lung Cancer Screening in Low-Risk Populations: Ethical Considerations, Technological Advancements, and Socioeconomic Challenges

IF 21 1区医学 Q1 ONCOLOGY

Journal of Thoracic Oncology

Pub Date : 2025-02-01 DOI: 10.1016/j.jtho.2024.08.036

Jianing Li MM, Yongsheng Zhang ME, Tong Fu MD, Ying Tong PhD

引用次数: 0

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